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Risk Surveillance and Assessment of Food Safety

in Shanghai

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Resume

• Name: Chunfeng Wu

• Position:

Shanghai Municipal Center for Disease Control and Prevention

• Education:

1999~2004 Bachelor of Medical Sciences

Public Health College, Fudan University

2008~ Reading for MPH in Fudan University

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Work Experience

• 2004.7~ Work in Department of Food Hygiene and Food-borne Disease Control

• 2008.5.22~2008.6.11Go to Sichuan province to provide health and epidemic prevention

after “Wenchuan Earthquake”

• 2008.8.24~2008.9.2Participate in a workshop held by U.S. CDCEpi-Ready Team : Foodborne Illness Response Strategies

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Framework of our jobs

Food-borne Disease Food-borne Disease SurveillanceSurveillance

Food ContaminationFood Contamination MonitoringMonitoring

Risk AssessmentRisk Assessment

Prevention, InterventionPrevention, Intervention

ResearchResearch EvaluateEvaluate

Food-borne Outbreaks Investigation and ResponseFood-borne Outbreaks Investigation and Response

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• Food-borne Diseases Surveillance

• Food Contamination Monitoring

• Others

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Food-borne Disease Surveillance

• In order to estimate the incidence of food-borne diseases in Shanghai

• Refer to the theory of FoodNet

• Establish the surveillance in the beginning of 2006

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FoodNet

• The project consists of active surveillance for foodborne diseases and related epidemiologic studies

Covers population of 37.6 million or 13.8% of the United States population

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Burden of Illness Pyramid Cases reported through passive surveillance represent fraction of

actual number of cases in community

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Food-borne Disease Surveillance

Passive surveillance system

Hospital(pathogen surveillance)

Community(food-borne diarrhea symptom

surveillance)

The Current Surveillance PyramidThe Current Surveillance Pyramid

School Drugstore

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• Select 4 communities every district

• Sample 120 residents every community

• Face to face investigation every month

• Collect the data of food-borne diarrhea symptom

• Deduce the incidence of food-borne diseases in general population

Community symptom surveillance

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• Select 6 hospitals every district

• Report all the cases in Enteric Diseases Clinic

obtain specimen such as stool

test Salmonella/E coli/Vibrio/Shigella

• Collect chemical food poisoning cases in emergency room

• Conclude the main causes of food-borne disease

Hospital pathogen surveillance

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• Drugstore surveillance2 stores every district

Explore the status of antidiarrhoeal drug and enteric antiseptics

One kind of data to estimate the burden

• School surveillance

4 schools every district

Determine the proportion of student absence for diarrhea

Incidence in a particular population

No formal surveillance

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• Report the food-borne outbreaks online

• In a prescriptive time

• Hospital district CDC municipal CDC

Passive surveillance

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0

50

100

150

200

250

300

bacterial chemical food poisons others

outbreaks

cases(×100)

Etiology analysis of Food-borne disease outbreaks and cases

During 1990 and 2000 in Shanghai, 68.8% foodborne outbreaks

caused by bacterial, 23.9% caused by chemical

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63.7% bacterial food-borne outbreaks caused by Vibrio parahaemolyticus

Etiology analysis of Food-borne disease outbreaks

and cases (bacterial )

0

20

40

60

80

100

120

140

160

180outbreaks and cases

outbreaks

cases(×100)

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Food Contamination Monitoring

• Determine the level of food contamination and its dynamic trend

• According to Global Environment Monitoring System - Food Contamination Monitoring and Assessment

(GEMS/Food) and national monitoring programme

• Establish the monitoring in 2002

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urban

Sample the monitoring sites such as supermarkets based on population distribution and living standard

2007

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Consumers’ routine purchases were imitated in those places for sampling food

• commissariat and commissariat products

• vegetable and vegetable products

• fruits and fruit products

• meat and meat products

• aquatic products

• milk and milk products

• Etc.

About 100 kinds and 5,000 pieces of food sample every year

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• Chemical contamination:• Heavy metal 

• Pesticide

• Veterinary drugs

• Food additive

• Etc.

Food contamination

• Bacterial contamination:• Salmonella

• Listeria monocytohenes

• Vibrio parahaemolyticus

• E coli O157

• Staphylococcus

• Etc.

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Others

Risk assessment:• Finish the assessment of lead and cadmium

• The main sources of lead and cadmium were rice, tint vegetables, fish and shrimp

• Overall, the dietary lead and cadmium intakes were safe in Shanghai residents

• Dietary cadmium intake was on a high level in children in whom P90 of cadmium intake is over PTWI

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My study:• Quantitative risk assessment of heavy metal in aquatic product  

• Finished gathering the data of aquatic product consumption• testing the concentration of lead and cadmium • Next to do

• Monte Carlo simulation ?

• software @RISK 5.0 analysis ?

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0.0780.2

0.41

0.0360.091

0.190.13

0.27

0.81

0.0920.24

0.39

00.10.20.30.40.50.60.70.80.9

Marine fish Fresh water fish mollusc crustacean 

 

Status of Pb in aquatic product(mg/Kg)

mean

P90

max

Pb concentration in mollusc is higher than in fresh water fish

Primary results

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0.0150.031

0.16

0.0130.0220.081

0.15

0.55

0.0790.18

0.91

00.10.20.30.40.50.60.70.80.9

1

meanP90

max

Status of Cd in aquatic product(mg/Kg)

Marine fish Fresh water  fish mollusc crustacean 

 

Cd concentration in mollusc and crustacean is much higher than in marine and fresh water fish

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• 《 Food Safety Law 》 had brought into effect from Jun 1st

CDC has responsibility of food-borne outbreaks investigation

FDA do this job now, we have little experience to deal with the field epidemiological investigation

Current situation

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• 2010 World Expo will be held in Shanghai

will be held from will be held from May to OctMay to Oct

70~75 70~75 millions millions

person-times will person-times will visitvisit

food consumption food consumption increaseincrease

more people will more people will eat in restaurantseat in restaurants

bacteria bacteria proliferate proliferate befittinglybefittingly

pesticide using pesticide using increaseincrease

food food contaminated contaminated incidentincident

food-borne food-borne outbreaksoutbreaks

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Development

• Increase the quality and sensitivity of surveillance and monitoring

• Practice food-borne outbreaks investigation and response

• Accumulate experiences of risk assessment

• Enrich the methods of intervention

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Activities

• Be familiar with Epidemiological methods and applications in food-borne outbreaks investigation and response

• Understand more about FoodNet, PulseNet…… How California conduct and act?

• Know some fast-testing methods of food contamination

• Participate in some jobs or workshops of exposure assessment , especially the use of model and software

• Learn to do intervention such as health education and communication

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